Read more about rituximab
How does it work?
Rituxumab is an antibody therapy that targets a type of immune cell called a B cell, which are thought to contribute to myelin damage in MS.
How is it taken?
Intravenous infusion every two weeks.
Rituximab in early relapsing MS
A phase 3 study involving 200 people with early relapsing MS or clinically isolated syndrome (CIS) began in 2016. Researchers will test if a new rituximab treatment protocol (infusion every six months) can improve clinical and MRI features of early relapsing MS. They'll compare rituximab with the licensed treatment Tecfidera, and a placebo.
The trial is due to finish in 2021.
Rituxumab in active progressive MS
A phase 2/3 study will compare the benefits of rituximab with the licensed treatment Copaxone in 60 people with active progressive MS. Researchers will test if rituximab can reduce relapse rates new lesion development, and if it can slow progression.
Rituximab will be taken as a infusion once every six months. The trial is due to finish in 2018.
Rituximab in primary progressive MS
Results of a phase 2/3 trial (OLYMPUS) were published in 2009. Ritixumib did not slow disability progression compared with placebo. But researchers reported that rituximab might be effective in younger people and those with active inflammation. More research would be needed to test potential benefits.
The trial involved 439 people with primary progressive MS.
Rituximab in secondary progressive MS
In March 2016 a phase 1/2 clinical trial testing the effectiveness of rituximab in secondary progressive MS was stopped early due to disappointing mid-trial results. This trial involved 27 people with secondary progressive MS, who received rituximab injections directly into the fluid around the spinal cord (intrathecal injection).
Results of a phase 2 trial (HERMES) were published in 2008. Rituximab was found to reduce new MRI lesions and relapse rates by 50% compared with placebo for one year.
The trial involved 104 people with relapsing MS.
Rituximab has been associated with severe side effects such as injection site reactions and progressive multifocal leukencephalopathy (a potentially fatal infection of the brain that has also been associated with Tysabri), though these have not occurred in studies to do with MS.
The most common side effects in studies in MS to date were reactions to the infusion and infections.
How does it compare with current therapies?
Rituximab is being compared with Tecfidera in early MS, and Copaxone in active progressive MS.
When will it be available?
Rituximab is already licensed for use in certain types of blood cancer, but not for MS. Larger phase 3 trials that demonstrate the effectiveness of rituximab would be needed before licensing could occur.